舒芬太尼用于全髋置换手术后患者自控静脉镇痛35例

目的 观察舒芬太尼用于全髋置换手术后患者自控静脉镇痛的临床镇痛效果和不良反应.方法 选择全身麻醉下行全髋置换手术且进行自控静脉镇痛的患者70例,随机均分为两组.对照组使用0.5 g/L吗啡,试验组使用1.5μg/mL舒芬太尼,背景剂量2 mL/h,单次给药剂量1 mL,锁定时间8 min.观察患者术后2,8,24,48 h的镇痛效果,记录镇痛泵使用情况、不良反应以及是否使用其他镇痛药物.结果 试验组视觉模拟评分在术后48 h低于对照组(P<0.05);两组患者口述评分的差异无统计学意义(P>0.05);对照组有2例患者因镇痛不全而肌肉注射哌替啶50mg;两组患者恶心、呕吐的发生率比较无统计学差异(P>0.05),均未出现嗜睡、呼吸抑制等其他不良反应.结论 舒芬太尼可安全有效地用于全髋置换手术的患者自控静脉镇痛,镇痛作用确切且略优于吗啡,不良反应与吗啡相似.

Postoperative Patient - Controlled Intravenous Analgesia with Sufentanil in 35 Cases of Total Hip Replacement Operation

Objective To observe the analgesic effect and side effects of sufenta nil on postoperative patient-controlled intravenous analgesia（PCIA） in the pati ents with total hip replacement operation.Methods Seventy cases of total hip rep lacement operation under general anesthesia were randomly divided into two group s,35 cases in each group.The two groups received 0.5 g/L morphine or 1.5 μg/mL sufentanil intravenously after surgery with basal dose of 2 mL/h,patient-contro lled analgesia（PCA） dose of 1 mL and the locking time of 8 min.The postoperativ e analgesic effect,PCA pump use,drug consumption and side effects at 2,8,24,48 h were recorded.Results The scores of visual analogue scale in the sufentanil gro up was less than that in the morphine group at 48 h after surgery（P〈0.05）.The scores of VRS in the two groups had no statistical difference（P〉0.05）.Two case s in the morphine group received 50 mg dolantin by intramuscular injection for i nsufficient analgesia.Similar nausea and vomiting were recorded in two groups（P〉0.05）.No other side effects were found in two groups.Conclusion Sufentinil cou ld be safely and effectively used in PCIA after total hip replacement.Sufentinil has better analgesic effect in comparison with morphine.Sufentanil and morphine have similar side effect profiles.